The war on emerging pathogens isn’t like any others. The war on drugs might well end with a new approach. The war on terrorism might eventually wind down. But the war on emerging pathogens is different. It will never end.
This conclusion is showing up fairly often in the scientific literature this year, from authors Ying Wu and George F. Gao, writing in Nature, to David M. Morens and Anthony S. Fauci writing in the PLOS Collections. All end with the same conclusion.
Or, with more words of explanation, Morens and Fauci wrote: “While it has become possible to eradicate certain infectious diseases (smallpox and the veterinary disease rinderpest), and to significantly control many others (dracunculiasis, measles and polio, among others), it seems unlikely that we will eliminate most emerging infectious diseases in the foreseeable future.”
In “Emerging Infectious Diseases: Threats to Human Health and Global Stability,” published by PLOS, the authors from the National Institutes of Health paint a serious, if not scary, picture that the world faces from emerging pathogens: “The inevitable, but unpredictable, appearance of new infectious diseases has been recognized for millennia, well before the discovery of causative infectious agents.
“Today, however, despite extraordinary advances in development of countermeasures (diagnostics, therapeutics, and vaccines), the ease of world travel and increased global interdependence have added layers of complexity to containing these infectious diseases that affect not only the health but the economic stability of societies.”
Not all emerging pathogens will use food and waterborne transmission sources, but enough do to make emerging pathogens every bit as important a food-safety issue as epidemiology or surveillance.
The college textbook definition for emerging pathogens includes any bacteria, virus or parasite that, through rapid evolution, overwhelms human defenses to cause illness or death. E. coli O157:H7 was an emerging pathogen for the 20 years before it busted out and began causing dozens of outbreaks each year.
And, just like then, there is now a new list of emerging pathogens being tracked by the National Institute of Allergy and Infectious Diseases. Pathogens that have been newly recognized in the past two decades are: Acanthamebiasis, Australian bat lyssavirus, Babesia, atypical, Bartonella henselae, Ehrlichiosis, Encephalitozoon cuniculi, Encephalitozoon hellem, Enterocytozoon bieneusi, Hendra or equine morbilli virus, Human herpesvirus 8, Human herpesvirus 6 and Parvovirus B19. And those on the re-emerging list include Enterovirus 71, Clostridium difficile, Mumps virus, Streptococcus, Group A and taphylococcus aureus.
Acanthamebiasis is found in fresh water and soil, Australian bat lyssavirus is a lot like rabies, and Babesia is a blood parasite. As for the re-emerging pathogens, a vaccine could eliminate mumps, but doctors tell patients they may not ever shake Clostridium difficile, which is often acquired during hospital stays.
Yet for thousands of scientists that work on emerging pathogens, both at the elite institutions and on research campuses across the country, most of the research sounds fairly normal. Take Dr. Anita Wright’s research, for example.
She is an associate professor at the University of Florida’s Emerging Pathogens Institute. Wright is among those in academia working to help the oyster industry in Apalachicola, FL, in the aftermath of hurricane Katrina.
Her research involves the species of Vibrio that makes people sick when they eat raw or undercooked oysters. Wright is looking for a post-harvest treatment for reducing or eliminating Vibrio without killing the oysters. She is also working with oysters in their natural estuarine habitat to find out how Vibrio infects shellfish in the first place.
Wright’s research is pretty typical of most of the work that goes on at UF’s Emerging Pathogens Institute (EPI), which is just one of the elite network of research laboratories around the country that have enlisted in this never-ending war.
With the state’s unique geography, UF established the institute to help protect its agriculture and tourism industries from new diseases.
Working out of a dozen BioSafety Level 2 labs – for handling bacteria and viruses that cause mild human diseases – and four of the more serious BSL 4 labs – for indigenous or exotic agents which may cause serious or potentially lethal disease after inhalation – EPI’s research has led in such areas as West Nile virus, dengue fever, H1N1 swine flu and citrus greening.
And EPI’s work on pathogens transmitted by food has also been among its major projects, involving E. coli O157: H7, Salmonella and Campylobacter.
Among the other major centers in the war on emerging pathogens are the Global Health and Emerging Pathogens Institute (GHEP) at the Icahn School of Medicine at Mount Sinai in New York City, the Institute for Emerging Pathogens and Immune Diseases at the Kirk School of Medicine at USC in Los Angeles, and the Center for the Study of Emerging and Reemerging Pathogens at Rutgers.
Some astounding research occurs at these institutions, and it often goes virtually unnoticed. For example, after 9/11, the virus that caused the flu pandemic of 1918 was right up there with smallpox and anthrax as possible biological agents that could be weaponized.
But that’s not been a concern since 2009 because the annual flu vaccine now protects against the virus that killed 675,000 Americans in 1918, thanks to the work of Adolfo Garcia-Sastre, the institute director at Mount Sinai.
GHEP is internationally recognized for expertise in RNA virus research and the molecular pathogenesis of influenza, HIV, dengue and Ebola viruses and hepatitis.
Photo Credit: University of Florida, Emerging Pathogens Institute
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